Create guidelines to prevent practice risks, eliminate patient harm, and protect patient privacy.
It is not unusual for dentists to receive requests to accept students, volunteers, and/or observers who are seeking an opportunity to follow them in their dental practice. Many high schools offer programs and courses that focus on health-related careers. Dentists also receive requests for shadowing experiences from college and vocational students.
Understanding what it means to be a dentist or dental professional is critical for individuals who are considering a career in the dental field. Shadowing and mentoring opportunities may be rewarding for the dentist and benefit the pre-dental student by fulfilling requisite application criteria. It is a great opportunity to promote the dental profession, but it is important to recognize that there are risks to your patients and your dental practice if you decide to accommodate such requests.
Before deciding to accept a student into an observation/shadowing experience, or as a volunteer, you should thoroughly explore the expectations of the observer/learner and the impact on your dental practice. Identify and validate the program associated with the student and understand the objectives that are expected to be achieved. It is important for the dental practice to differentiate between shadowing or observing versus volunteering, or a formal clinical rotation where direct patient care is provided.
An observing or shadowing experience allows an individual to watch a dental professional provide care to patients in a clinical setting. Shadowing experiences are generally used as an introduction to the profession. They might also provide the dentist or hygienist with an opportunity to mentor and model professionalism in the care and treatment of patients with various dental conditions. It is also an opportunity to demonstrate sensitive communications with patients from diverse social cultural and financial backgrounds.
The student may be associated with a formal school or vocational program. In many instances, they are pre-dental students who are required to volunteer or shadow a dentist or dental hygienist as part of an application process. In most cases, those individuals will not have a clinical instructor. Therefore, in order to prevent any harm, the dentist should decide whether to limit a student’s interaction with patients based on the student’s education and training.
Regardless of the shadowing or volunteer situation, it is vital that patient’s rights, privacy, and confidentiality are protected at all times. It is the responsibility of the sponsoring dental practice to ensure that the observer or learner is mature enough to understand the expectations of the sponsoring dental professional.
Risk Management Guidelines
The following general guidelines should be considered to reduce the risk of breaching patient confidentiality and other risks to the practice. They may also help you identify the specific goals and objectives of the learner to make the shadowing or volunteer experience mutually rewarding for the student, patient, and the dental practice.
- Request a formal written request with length of time, purpose, objectives, and expectations of the experience.
- Consider a brief application form or a resume that contains personal information, including parent names and contact information, name of the school in which the student is attending, current grade level, any counselor/advisor/faculty from the school, and specific purpose of the shadowing or volunteering experience.
- Interview the student to determine the type of program in which he/she is enrolled. The interview will provide an opportunity to assess the level of maturity and communication skills.
- Request one or two references or recommendations from a faculty member or other individual that can confirm the student’s character.
- Consider a liability waiver or release form executed by the parents or guardian if the student is a minor or if there are any hazards in the setting such as exposure to chemicals/lasers or biological exposures.
- Limit student observers to those who attend a structured program which provides instructions regarding professionalism, confidentiality, and state and federal privacy laws.
- Create a name badge for the student to clearly identify their role to office staff and patients.
- Develop a process to introduce the student to patients and ask patients for permission to allow the student to observe the clinician-patient interactions. Inform the patient that he or she may decline the permission request. Document the patient’s consent.
- Develop a “Code of Conduct” and review the expectations for conduct with the student. At a minimum, the code of conduct should include guidelines for professionalism, abusive language, breach of confidentiality, harassment, appropriate use of mobile devices, and dress code.
- Provide clear expectations regarding the appropriate time for questions and answers during the dentist-patient interaction.
- Discuss infection control standards, including absence from the dental office at the onset of symptoms of illness. Request proof of immunizations.
- Provide orientation to assure that the student is prepared for the shadowing experience, identify the dentist who the student will be shadowing, as well as the sponsoring dental practice’s expectations.
American Student Dental Association Shadowing Guide and Log. http://www.asdanet.org/uploadedFiles/Membership_Resources/Predental/Shadow%20Guide%20and%20Log.pdf
American Dental Education Association Shadowinghttp://www.adea.org/GoDental/Application_Prep/Preparing_for_Dental_School/Shadowing.aspx
Contact the Department of Patient Safety and Risk Management for guidance and assistance in addressing any patient safety or risk management concerns.
The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each healthcare provider in light of all circumstances prevailing in the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.